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Women With Gestational Diabetes Not Tested for Diabetes Postpartum

Insufficient numbers of women who had gestational diabetes during pregnancy are being screened for diabetes in the first year postpartum, according to a retrospective study. Despite gestational diabetes being a known risk factor for the development of diabetes mellitus, and physicians’ organizations suggesting screening for diabetes in the postpartum period, less than half of women in the study (44.7%) actually were screened.

"These women are really at high risk of developing diabetes in their lifetime," said Frédéric Bernier, MD, the study’s lead investigator and a fifth-year endocrinology resident. "The [screening] rate that we found is too low."

The study examined 75 women who had delivered children between March 2002 and June 2005 and has gestational diabetes. The mean age of patients was 30.7, mean weight before pregnancy was 76 kg, mean body mass index was 29, and mean gestational age at delivery was 38 weeks.

Investigators examined if factors such as mode of delivery, baby’s weight, family history of diabetes, personal history of gestational diabetes, smoking, drug and alcohol intake, treatment with insulin during pregnancy, use of insulin during delivery, shoulder dystocia, mother’s age, weight before pregnancy, consultation with an endocrinologist during pregnancy, specialist consultation for a high-risk pregnancy, a pap test postpartum, or other factors influenced screening for diabetes postpartum.

In initial statistical analysis, investigators identified a postpartum pap test, smoking, insulin therapy during pregnancy, insulin therapy during birth, and consultation with an endocrinologist during pregnancy as predictors of screening for diabetes postpartum (P <.05). Further statistical analysis showed that only smoking status (57% vs. 27%, P =.022) and insulin therapy during pregnancy (59% vs. 32%, P =.007) were predictive of postpartum screening for diabetes.

"It makes sense that women who received insulin therapy during pregnancy were screened," said Dr. Bernier. "They and their doctors are likely concerned about diabetes mellitus. It could be that women who are smoking are less concerned about their health. They may not be visiting the doctor to be screened for diabetes mellitus."

Dr. Bernier suggested that interventions might be a good idea to increase postpartum screening for diabetes. "It might be a good idea that these women receive a follow-up phone call about six months after their delivery, asking if they have been screened for diabetes," said Dr. Bernier.

[Presentation title: Prevalence and Predictors of Diabetes Mellitus Screening in the First Year Post-Partum of Women with Gestational Diabetes: A Retrospective Study. Abstract P4-128] 89th annual meeting of the Endocrine Society (ENDO).

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